Home health care is an integral part of community-based long term care. In rural areas, health care services for older adults may be limited in scope and accessibility; research on rural home health care is limited. The purpose of this ethnographic study is to describe rural home health care, continuity of care, and related community support for older adults from the perspective of those involved in or experiencing the care (nurses, administrators of hospitals and home health agencies, patients, family, and community residents). The specific aims are: 1) to describe the patterns and processes of home health care services for older adults in rural Colorado; 2) to describe the continuity of care from hospital to home health and other long term care services in the rural community: 3) to describe the patient, family and community support and involve, sent in rural home health care; 4)to identify and describe problems in the delivery process of rural home health care; and 5) to compare and contrast the patterns, processes and problems in urban and rural home health care. This study is timely and significant; demographic and political trends influencing rural health services indicate a need for research to facilitate health policy formulation a long terms goal of the study. Using an ethnographic design, the study will be conducted in home health, agencies and hospitals in two, 3-5 county rural areas of Colorado in which a high proportion of the population is over age 60. Research ,methods will include participant observation and non- structured ethnographic interviews. Ethnographic analysis of taped interview transcripts and field notes will lead to development of categories, domains, and themes emerging from the data, and production of an indepth description of the phenomenon from the perspective of those most closely involved. The study is planned for 4 years; the results of the study and the comparison of rural and urban home health care will be useful to nurses and others involved in planning long term care and related health policy.